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Study: Glaucoma drainage device increases risk for postoperative hemorrhage

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Delayed suprachoroidal hemorrhage may occur more commonly after glaucoma drainage device procedures than after trabeculectomy, a study suggests. Because outcomes after delayed suprachoroidal hemorrhage are poor, surgeons should understand the potential ocular and systemic risk factors for the condition.

To determine the frequency, risk factors and outcomes of delayed suprachoroidal hemorrhage after glaucoma surgery, V. Swetha E. Jeganathan, MBBS, and colleagues retrospectively reviewed medical records for 2,752 patients who underwent glaucoma procedures during a 10-year period. The study results were published in the October issue of British Journal of Ophthalmology.

Overall, the investigators identified 29 cases of delayed suprachoroidal hemorrhage. They were then compared with a matched control population that underwent comparable procedures but had not developed the condition.

The investigators found that the incidence of postoperative hemorrhage was higher after drainage device implantation than after trabeculectomy (P < .0001).

Risk factors included a postop IOP of 3 mm Hg or less (P < .001), aphakia (P < .001), prior intraocular surgery (P < .002), hypertension (P < .001), anticoagulation (P = .002), ischemic heart disease (P = .001) and respiratory disease (P = .008).

Visual outcomes for patients with hemorrhages were significantly worse when compared with controls with no hemorrhages (P = .002), according to the study.